Post written by Mako Koseki, MD, and Daisuke Kikuchi, MD, PhD, from the Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.

In this video, we present a case of a refractory esophageal stricture caused by anastomosis of gastric tube reconstruction for advanced esophageal carcinoma. We treated the stricture with radial incision and cutting (RIC) using ultrathin endoscopy.

Using new devices we specifically developed for ultrathin endoscopy (an endoscopic submucosal dissection knife [Endosaber Fine; SB Kawasumi Co, Ltd, Tokyo, Japan] and a transparent hood [Nichendo; Fujifilm Co, Tokyo, Japan]), we were able to complete RIC without adverse events and showed that RIC using ultrathin endoscopy could be a safe, feasible, and useful treatment.

Until now, RIC had almost always been treated with normal-caliber endoscopy, although most strictures do not allow endoscopes to pass through.

However, using ultrathin endoscopes, we could make incisions and exfoliations with better scope maneuverability and constant direct vision, especially in the narrow strictures. We also could perform gastric deaeration frequently and use less anesthetic agent. This could possibly broaden the range of patients with narrow esophageal strictures who could undergo the RIC procedure.

Led by Dr Kikuchi, this case shows an example of a way to accurately treat refractory esophageal strictures that are narrow.

Endoscopic image before radial incision and cutting procedure. Before the procedure, even the ultrathin endoscope with transparent hood could not pass through the stricture.

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.